Browsing by Author "Çabuk, D"
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Item Predictive and Prognostic Factors in Ovarian and Uterine CarcinosarcomasCicin, I; Özatli, T; Türkmen, E; Özturk, T; Özçelik, M; Çabuk, D; Gökdurnali, A; Balvan, Ö; Yildiz, Y; Seker, M; Özdemir, N; Yapar, B; Tanriverdi, Ö; Günaydin, Y; Menekse, S; Öksüzoglu, B; Aksoy, A; Erdogan, B; Hacioglu, MB; Arpaci, E; Sevinç, ABackground: Prognostic factors and the standard treatment approach for gynaecological carcinosarcomas have not yet been clearly defined. Although carcinosarcomas are more aggressive than pure epithelial tumours, they are treated similarly. Serous/clear cell and endometrioid components may be predictive factors for the efficacy of adjuvant chemotherapy (CT) or radiotherapy (RT) or RT in patients with uterine and ovarian carcinosarcomas. Heterologous carcinosarcomas may benefit more from adjuvant CT. Aims: We aimed to define the prognostic and predictive factors associated with treatment options in ovarian (OCS) and uterine carcinosarcoma (UCS). Study Design: Retrospective cross-sectional study Methods: We retrospectively reviewed the medical records of patients with ovarian and uterine carcinosarcoma from 2000 to 2013, and 127 women were included in this study (24 ovarian and 103 uterine). Patients admitted to seventeen oncology centres in Turkey between 2000 and December 2013 with a histologically proven diagnosis of uterine carcinosarcoma with FIGO 2009 stage I-III and patients with sufficient data obtained from well-kept medical records were included in this study. Stage IV tumours were excluded. The patient records were retrospectively reviewed. Data from 104 patients were evaluated for this study. Results: Age (>= 70 years) was a poor prognostic factor for UCS (p=0.036). Pelvic +/- para aortic lymph node dissection did not affect overall survival (OS) (p=0.35). Macroscopic residual disease was related with OS (p<0.01). The median OS was significantly longer in stage I-II patients than stage III patients (p=0.03). Adjuvant treatment improved OS (p=0.013). Adjuvant radiotherapy tended to increase the median OS (p=0.075). However, this tendency was observed in UCS (p=0.08) rather than OCS (p=0.6). Adjuvant chemotherapy had no effect on OS (p=0.15). Adjuvant radiotherapy significantly prolonged the median OS in patients with endometrioid component (p=0.034). A serous/clear cell component was a negative prognostic factor (p=0.035). Patients with serous/clear cell histology for whom adjuvant chemotherapy was applied had significantly longer OS (p=0.019), and there was no beneficial effect of adjuvant radiotherapy (p=0.4). Adjuvant chemotherapy was effective in heterologous tumours (p=0.026). In multivariate analysis, the stage and chemotherapy were prognostic factors for all patients. Age was an independent prognostic factor for UCS. However, serous/clear cell histology and radiotherapy tended to be significant prognostic factors. Conclusion: The primary location, the histological type of sarcomatous and the epithelial component may be predictive factors for the efficacy of chemotherapy or radiotherapy in UCS and OCS.Item Atezolizumab combined with chemotherapy in the first-line treatment of extensive-stage small cell lung cancer: a real-life data of the Turkish Oncology GroupGürbüz, M; Kutlu, Y; Akkus, E; Köksoy, EB; Köse, N; Öven, BB; Uluç, BO; Demiray, AG; Erdem, D; Demir, B; Turhal, NS; Üskent, N; Akbas, S; Selçukbiricik, F; Inal, A; Bilici, A; Ölmez, ÖF; Çabuk, D; Ünal, Ç; Hizal, M; Sendur, MAN; Korkmaz, M; Karadurmus, N; Ertürk, I; Göksu, SS; Tatli, AM; Güven, DC; Kiliçkap, S; Paksoy, N; Aydiner, A; Çinkir, HY; Özkul, Ö; Öztürk, A; Balli, S; Kemal, Y; Erdogan, AP; Er, Ö; Yumuk, PF; Demirkazik, APurpose Atezolizumab has been shown to be effective and safe in randomized trial in the first-line treatment of extensive-stage small cell lung cancer (SCLC). However, there are limited real-life data on atezolizumab. In this study, we aimed to determine the real-life efficacy and safety of atezolizumab combined with chemotherapy in the first-line treatment of extensive-stage SCLC. Methods This trial is a retrospective multicenter study of the Turkish Oncology Group, which included extensive-stage SCLC patients who received atezolizumab combined with chemotherapy in a first-line treatment. The characteristics of the patients, treatment and response rates, and PFS and OS are presented. Factors associated with PFS and OS were analyzed by univariate and multivariate analysis. Results A total of 213 patients at the 30 oncology centers were included. The median number of chemotherapy cycle was 5 (1-8) and atezolizumab cycle was 7 (1-32). After median 11.9 months of follow-up, median PFS and OS was 6.8 months (95%CI 5.7-7.8), and 11.9 months (95%CI 11-12.7), respectively. The ORR was 61.9%. ECOG-PS (p = 0.002) and number of metastatic sites (p = 0.001) were associated with PFS and pack-year of smoking (p = 0.05), while ECOG-PS (p = 0.03) and number of metastatic sites (p = 0.001) were associated with OS. Hematological side effects were common and toxicities were manageable. Conclusion This real-life data confirm the efficacy and safety of atezolizumab in combination with chemotherapy in first-line treatment of extensive-stage SCLC.Item The prognostic impact of Her2 status in early triple negative breast cancer: a Turkish Oncology Group (TOG) studyÖzyurt, N; Alkan, A; Gülbagci, B; Seyyar, M; Aydin, E; Sahbazlar, M; Türker, M; Kinikoglu, O; Yerlikaya, T; Dinç, G; Aytaç, A; Kalkan, Z; Ebinç, S; Gültürk, I; Keskinkiliç, M; Isleyen, ZS; Çaglayan, D; Türkel, A; Aydin, E; Sakalar, T; Sekmek, S; Yildirim, N; Koçak, S; Okutur, K; Özveren, A; Dursun, B; Kitapli, S; Eren, OÖ; Beypinar, I; Hacibekiroglu, I; Çabuk, D; Karaman, E; Acar, Ö; Paydas, S; Eryilmaz, MK; Demir, B; Oruç, Z; Yilmaz, M; Biricik, FS; Salim, DK; Tanriverdi, Ö; Dogan, MThe studies evaluating the impact of Her2 levels in neoadjuvant setting have conflicting data. The aim of the study was to evaluate the prognostic impact of Her2 status in early triple negative breast cancer(TNBC). In the study TNBC patients who were treated with neoadjuvant chemotherapy (NAC) and surgery were analyzed retrospectively. The primary aim of the study was to analyze the impact of Her2 status(Her2-0 and Her2-low) on pathological complete response (pCR). The secondary objectives were disease free survival (DFS) and overall survival (OS). 620 female triple negative breast cancer patients were evaluated. 427 patients (68.9%) had Her2-0 and 193(31.1%) had her2-low pathology. The pCR rates were similar between Her2-0 and Her2-low patients (33.0% vs. 27.5%, p = 0.098). Although Her2-0 group has better DFS (106 vs. 50 months, p = 0.002), in multivariate analysis it had a HR of 0.74 (p = 0.06). In addition, OS was similar (131 vs. 105 months, p = 0.13) with a HR of 0.88 (p = 0.61). In multivariate analysis; presence of LVI (HR:2.2 (95% CI 1.1-3.5) p = 0.001), Clinical stage T1/T2 (HR:0.39 (95% CI 0.2-0.6) p < 0.001) and lymph node negativity (HR:0.35 (95% CI 0.1-0.9) p = 0.03) were independent factors for OS. Although there were pathological and clinical differences, the pCR, DFS and OS were similar between Her2-0 and Her2-low TNBC patients. The importance of Her2 status of TNBC in neoadjuvant setting should be further studied.